A Case of Type B Lactic Acidosis in Acute Leukemia

Type B lactic acidosis is a rare condition in patients with solid tumors or hematological malignancies. Although there have been several theories to explain its mechanism, the exact cause of lactic acidosis remains to be discovered. Lactic acidosis is usually related to increased tumor burden in patients with malignancy. We experienced a case of lactic acidosis in a 39-year-old man who visited an emergency room because of dyspnea, and the cause of lactic acidosis turned out to be recurrent acute leukemia. Chemotherapy relieved the degree of lactic acidosis initially, but as the disease progressed, lactic acidosis became aggravated. Type B lactic acidosis can be a clinical presentation of acute exacerbation of acute leukemia.

Clinical Observation of 12 Farmers Who Believe Themselves to Have Suffered from Chronic Pesticide Intoxication

BACKGROUND/AIMS: We assessed twelve cases of suspected chronic pesticide intoxication, with medically unexplained physical symptoms. METHODS: Complete blood cell count (CBC), blood chemistry, routine urinalysis, chest X-ray, ECG, gastrofiberscopy, abdominal ultrasonography, neuroselective sensory nerve conduction threshold, and psychological assessment were performed on 12 farmers who believe themselves to have suffered from chronic pesticide intoxication. RESULTS: No specific abnormalities were observed on CBC, routine urinalysis, chest X-ray, ECG, gastroscopy, abdominal ultrasonography, or peripheral nerve conduction velocity test. They persistently manifested helplessness, depression, and anxiety. The results of both psychological assessment and general physical examination revealed the following clinical features: depression (8 cases), multiple chemical hypersensitivity syndrome (2 cases), alcoholism (1 case), and religious preoccupation (1 case). CONCLUSION: In those living in the western rural area of South Korea, depression is a prominent ongoing presentation in pesticide-exposed farmers, in addition to unexplainable physical symptoms.

Incidental Finding of a Precaval Right Renal Artery on CT: A Case Report

The right renal artery passing anterior to the inferior vena cava is a rare variant of the normal renal arterial anatomy, and identifying this anomaly is important for the planning of minimally invasive renal surgery. The presence of this precaval right renal artery was detected on the contrast-enhanced CT scan by identifying the right renal artery passing anterior to the inferior vena cava. We report here on a case of a precaval right renal artery as a main supplying artery, and this was incidentally found on CT.

Giant Presacral Schwannoma: A Case Report

Most giant sacral schwannomas are associated with moderate to massive bone destruction before they extend into the presacral space. These lesions can, on rare occasions, manifest as a giant tumor in the presacral space without bone destruction. We report here on the image findings of a presacral giant schwannoma in a 65-year-old man. On ultrasound and CT, the tumor appeared as an inhomogenous, well-demarcated mass that demonstrated some cystic changes and peripheral calcifications without sacral bone destruction. On the MR imaging, the tumor showed as an inhomogeneous, encapsulating mass with low signal intensity on both the T1 and T2-weighted images, except for some areas that showed cystic change.

CT Findings of Acute Appendicitis in Children

Acute appendicitis is the most common cause of surgical abdomen in children. Because of the various locations where you can find the appendix and the different presentation for the symptoms of appendicitis, the clinical diagnosis of appendicitis is often difficult in children, and radiologic diagnosis is becoming increasingly important. Being familiar with the findings of acute appendicitis on the MDCT axial image and the multiplanar reformation images may aid the physician in reaching an early diagnosis and so prevent complications and reduce negative appendectomy rates.

Laparoscopic Partial Splenectomy for Splenic Pseudocyst

Splenic preservation and conservative management are now accepted norms when dealing with splenic pathologic conditions. Recently, we managed one case of splenic pseudocyst by successfully performing partial splenectomy via a laparoscopic approach. This case report possibly the first case report of its kind in Korea, describes laparoscopic partial splenectomy for an undiagnosed and suspected benign splenic lesion. A thorough understanding of splenic anatomy permits laparoscopic partial splenectomy with the resultant benefits, including a decreased risk of postsplenectomy sepsis by preserving splenic function, short hospital stay, smooth convalescence, superior cosmesis, and non-recurrence. The success and relative ease of performing this procedure will pave the way for its future use in other selective cases involving splenic pathology.